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The Effective Strategy of the Health Care Organization

2. The implications for health care management of the changes facing health care delivery and management in the 21st century are numerous. Cost containment is critical, particularly since the economy is a labored one and the latest health care reforms will cut health care profits. Health care management needs to balance cost containment with quality of care, ensuring that neither is shortchanged, or else the ability to serve patients well will be compromised. Changing social norms with respect to health care have also placed heavier demands on hospitals and other health care organizations. In contrast with our society of 50 years ago, people go to the hospital more often and have a far larger number of procedures than before. In addition, women rarely give birth at home as in the past, and most people die in the hospital now. Common ailments such as colds and flu that most people just stayed home and rested for are now considered a reason to see a doctor, even though there are no medications that cure these. The changing demographic composition of society also places new demands on health care organizations, since many patients now speak a foreign language, and the hospital must have staff that can communicate with them. Technology is constantly developing, which requires retraining of personnel and continuing investment in new equipment.

Social experiments are another factor in the changing health care scene. They are an alternative to a randomized control trial; they introduce "naturally occurring events or new social policies or programs...in which people have different exposures that researchers can document by collecting and analyzing data" (Cooper, Hill, & Powe, 2002, p. 477). An example is the State Children's Insurance Program, which was an experiment in insuring children whose family incomes fell into the gap between being too low to afford private insurance and too high to qualify for Medicaid (Cooper, Hi...